Community hospital expands role in patient care.
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Taking a "plunge" into the community puts trustees in touch with the real people affected by decisions made in the boardroom. It's an education that goes beyond facts, figures, and policies. Trustees and execs at Memorial Health System in South Bend, Ind., have used this method for several years to put a face on social issues that influence their community's health.
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"A healthy community isn't defined just by its rates of infection or inoculation," says Lawrence White Jr., CEO of St. Patrick Hospital, a winner of this year's NOVA Awards. Working with a wide array of community and health care organizations, the five winning hospitals have tackled knotty community problems--even ones not directly related to health care--in ways that reach beyond their traditional turf.
Health care organizations throughout Michigan continue to adjust to tightening budgets. Even so, there is a growing need to understand and act upon the more global and vexing health issues facing local communities. Managed care has greatly impacted community hospitals as well as community health agencies. The need to do more with less, and to do it more effectively whenever possible, has become a challenge for all involved in the health delivery system.
Three of the major issues affecting health care today are global in nature: poverty, violence and the aging of the American population. In the absence of a concerted national effort to deal with them, communities across the country are experimenting with their own local solutions. The Valencia County Coalition in New Mexico, for instance, is breaking down the barriers between low-income residents and the state's Medicaid managed care program. Another example: The DeKalb Medical Center in Decatur, Ga., opened a unit to treat elderly patients' acute medical problems and keep them functional so they can go straight home from the hospital rather than to subacute or skilled nursing care.
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The number of malnourished children in Africa continues to increase. It has been proven that such tendency could be stopped or even reversed if the lessons learnt from successful community nutrition programs were applied. The authors do not deny the role that poor socio-economic conditions play on malnutrition, and that those conditions need to be improved for a long-lasting impact, but they also argue that it is possible to act in parallel and get positive results, without waiting for macro-economic improvements. Successful projects such as those from Tamil Nadu in India, Iringa in Tanzania, Secaline in Madagacar, the PNC in Senegal, the AIN-C in Honduras, Prosen in Cameroon all applied the same principles and a similar approach. To reach success, international nutrition experts identified eighteen principles which should be used when designing and monitoring a community nutrition program, and there are also five phases to follow during the design stage. Finally, the authors suggest that if nutrition seems to often be underfunded, it is mainly because nutritionists in general have not been able to come up with feasible and well-conceived programmes. A few ideas are provided on how to access financing from health sector programs, by ensuring that the community nutrition programme helps implement certain aspects of those health sector programs. The conclusion is that there is no excuse not to start improving the nutritional status of African children now.